Pet insurance can help you manage vet costs and better afford emergency care, but policies and coverages often differ dramatically. Learn how to evaluate a pet policy and the company offering it to pick the best one for your pet.
Pet insurance plans offer three main types of coverage: accident and illness, accident-only, and wellness plans. For example, an accident and illness plan would typically cover treatment for injuries and illnesses, including testing and diagnostics, prescriptions, and preventive care. Be aware of plan exclusions (items that aren’t covered) and dollar limits on coverage.
Pet insurance charges a premium, has a deductible, and has a coinsurance percentage that you pay on bills once the deductible is met. It also may have annual, per-incident, and lifetime limits on covered services. You typically need to pay for care upfront, then file a claim with the insurer yourself. This is usually an easy procedure done via app, online, fax, or mail. Once the claim is approved (typically within 30 days), you’ll be reimbursed.
Incurable preexisting conditions typically are excluded from coverage, such as cancer, diabetes, hip dysplasia (on both sides, even if it’s only presented on one), arthritis, cataracts, and heart disease. Other preexisting conditions that are considered curable may be temporarily excluded but later eligible for coverage once your pet has been symptom-free for a certain period of time, such as 12 months.
If you can afford the monthly premium but can’t afford to pay a $1,000 to $5,000 vet bill out of pocket, you should consider getting pet insurance. But even if you can cover a large vet bill, you might want a plan to manage vet costs via a monthly premium. It’s essential to compare different plans and their components to best suit your needs. And pay attention to waiting periods, deductibles, coinsurance percentages, exclusions, and limits.
What’s not covered depends in part on the type of plan you get (accident-only, accident and illness, comprehensive with wellness benefits). Generally, preexisting conditions, elective procedures, vaccinable illnesses, pregnancy, and secondary conditions aren’t covered. Coverage may also be restricted based on age and only offered up to plan limits—these may be per-incident, annual, and lifetime.
According to the North American Pet Health Insurance Association (NAPHIA), the average monthly premium in 2021 for accident-and-illness plans for dogs was $48.66. For cats, it was $28.57. Accident-only plans were cheaper at $19.93/month for dogs and $10.85/month for cats, but don’t cover illnesses such as cancer, infections, and digestive issues.
Preexisting conditions in pets are any conditions your pet experienced, whether diagnosed or undiagnosed, before enrolling in pet insurance or during a policy’s initial waiting period. Cancer, diabetes, and bilateral conditions such as hip dysplasia are common examples of preexisting conditions that are excluded from coverage.
An insurance deductible is the amount you pay for covered services before coverage kicks in.
This is the percentage you pay for covered services once your deductible has been met.
This is the maximum amount the insurance company will pay per year. Once you’ve been reimbursed this amount, any remaining expenses for the year are your responsibility.
This is the amount up to which the insurance company will spend during the life of your pet—coverage ends after this point. If, for example, the limit is $25,000 and you’ve been reimbursed $25,000, your coverage would end.
An insurance premium is the amount of money you pay on a regular basis in exchange for an insurance policy.
Pet wellness plans are types of pet care coverages that help owners afford regular examinations and other preventive treatments that may reduce future health complications in their pets.
Pet insurance won’t pay for any condition beyond its per-incident limit, regardless of which type of plan you choose. For example, if your plan has a $5,000 per-incident limit for diabetes coverage, once you’ve been reimbursed $5,000 for diabetes-related claims, you’ll be responsible for all future costs.
A claim is what you file in order to be reimbursed for covered services. You can often submit claims by email, postal mail, and fax, or through your online account or the insurer’s mobile app.
Procedures that are considered elective, such as declawing and tail docking, are nearly always excluded from coverage.
A waiting period of two weeks is typical for accident and illness insurance for pets. It’s the time after coverage begins until the insurance company will start paying benefits.